Orthodontics Residencies - Pluses and Minuses

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SoonToBeDrOrthoBae

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Hi everyone!

I'm currently in the orthodontics application cycle. I was wondering if anyone knew of any schools that were AMAZING in their experience, or if there were schools that I shouldn't even consider.

The qualities I'm looking for in an orthodontics program are: class and faculty diversity, modern technology teaching (lingual braces, clear aligners, etc), clinical > research, partnership with OMFS, and location.

Thanks so much! I hope I hear back before August 1st when I turn my apps in!!!

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A paid stipend would be at the top of my list. Residency will teach you the BASICS. The rest you will learn in the real world.
Definitely that would be a plus! I just figured if I was going to be paying for residency I'd want to learn basically all that I want to learn in the real world there and have to pay minimal for CE courses. I'm not sure if that's just me being ambitious.
 
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Hi everyone!

I'm currently in the orthodontics application cycle. I was wondering if anyone knew of any schools that were AMAZING in their experience, or if there were schools that I shouldn't even consider.

The qualities I'm looking for in an orthodontics program are: class and faculty diversity, modern technology teaching (lingual braces, clear aligners, etc), clinical > research, partnership with OMFS, and location.

Thanks so much! I hope I hear back before August 1st when I turn my apps in!!!
The good program is the one that you attend. I visited other programs for interviews but 1-day visit wasn’t enough for me to fully learn about their strengths and weaknesses. So I can only speak about the program that I attended. It’s a good 2-year program that put more emphasis on clinical training and less on research. Because it didn’t put too much emphasis on research, getting a MS degree was very easy and less time consuming for me…and that was a good thing. I am glad that I went to a very low tech program that had very limited budget. My program director made us, residents, fabricate all the intraoral appliances by ourselves, made us call our patients for appointments, and made us treat patients without the assistant. I had learned a lot. When I graduated, I had no problem adapting to working at 3 different busy corp offices that booked 80-100 patients a day. That was many many years ago. I’ve just looked at the most recent video of my program. The current residents appear to be a lot more “spoiled” now than when I was there. They have newer chairs. They have all the high tech toys like intraoral scanner and CBCT etc.

IMO, the good program is the program that treats you like a lowly dental student…..that makes you do more clinical/lab work by yourself and does not provide you any assistant. You may not like it now but you will thank yourself later for choosing such program. When you have to do the manual labor by yourself, your hand skills will improve greatly…you bend wires faster, you place a steel ligature on a severely rotated tooth faster etc. You should learn to do the work of an assistant and of a lab technician as much as possible. Being able to multi- task is very important, especially when you first open your new practice or when you work at an office that doesn’t give you enough assistants. When you graduate, you will be able to work at any type of office. The offices that lack modern equipment and have low overhead (ie Corp offices) usually can afford to pay you a lot more than the offices that have high overhead. Don’t be afraid to work at busy offices because the more cases you treat, the more experience you will gain. With busy schedule, you have to teach yourself how to manage the chair time more effectively and to come up with clinical tricks to get tx done faster. Working in such office environment is like doing another year of GPR for general dentists. It’s better than taking expensive (and not very helpful) CE classes.

You need to learn the basics first. When you have firm grasp of the basics (especially in diagnosis and tx planning) of ortho, you should have no problem learning new methods and incorporating new technology into your business. Learning how to use a new equipment is not hard. Companies will send people to your office to train you and your staff because they desperately want you to buy their products. Having practiced ortho for many years and having been very happy with my job, I’d like to offer you this advice. Try to keep everything as simple (ie simple tx plan, fewer wire changes, using fewer appliances, simple but efficient mechanics etc) as possible and you will enjoy your job more. If something has been proven to work well and to be cheap and reliable, don’t change it.

Since you have to pay for your ortho training, you should pick a cheap program. And the shorter the length of the training the better it is. If you really want to become an orthodontist, don’t be picky….apply to as many programs as possible. It’ll cost a lot more money when you have to reapply.
 
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You need to learn the basics first. When you have firm grasp of the basics (especially in diagnosis and tx planning) of ortho, you should have no problem learning new methods and incorporating new technology into your business.

Since you have to pay for your ortho training, you should pick a cheap program.
Exactly. LEARN THE BASICS. What's the old saying? You can't run if you didn't learn to walk. During my 1st year ...my ortho residency program forced the residents to use OLD techiques from the past. Begg. Tip-Edge. Standard Edgewise brackets. Functional appliances. With these techniques .... a resident had to understand and be proficient in WIRE BENDING. We hated it and thought it was a waste of valuable time. But now I know better. During our 2nd year ... we were allowed to use Pre-adjusted Straight Wire brackets. Comprehensive aligner tx was not around back then lol.

I see all the new orthodontists going through the DSO I work at. I see their work because I substitute for them when they are on vacation, or out sick. Most of them are adverse to wire bending. It's like they were never taught the fundamentals of moving teeth. They don't finish their cases in stainless steel archwires, adjustable archwires with proper adjustments. Closing extraction spaces without correcting the deep OB 1st. Inadequate upper incisor torque during space closure, etc. etc.

Aligner tx has even made this situation worse. Orthodontists relying too much on aligners to do the work.

As for choosing an ortho program. I attended a stipend paying, hospital based program on the east coast. Lots of extractions. Lots of orthognathic cases/craniofacial cases. Lots of Tweed concepts, Charles Burstone (extraction protocols). Well. After residency .... I moved back to Arizona. Well .... at that time the west coast was mostly NON-EXTRACTION concepts. Phase 1 treatment. RPE. Pendex. Hilgers. Herbst. T-Rex. Tads with upper molar distalizations using Niti wire (Giannely). Anything to treat nonextraction. Essentially the OPPOSITE of what I was trained for. I associated with a great orthodontist (18 mos later bought that practice) and learned this nonextraction technique. I used that nonextraction technique for years in private practice. Served me well. Funny thing is now working for a DSO .... I'm back to the simpler extraction treatment without appliances.

Point is. A residency should teach you the basics. The concepts you eventually use will be different depending on where you plan to practice. The thesis intent is to train you to be a discerning reader of publications, articles, for profit companies bragging about how good their product is, or speakers at a convention who have a financial interest in their lecture.
 
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Exactly. LEARN THE BASICS. What's the old saying? You can't run if you didn't learn to walk. During my 1st year ...my ortho residency program forced the residents to use OLD techiques from the past. Begg. Tip-Edge. Standard Edgewise brackets. Functional appliances. With these techniques .... a resident had to understand and be proficient in WIRE BENDING. We hated it and thought it was a waste of valuable time. But now I know better. During our 2nd year ... we were allowed to use Pre-adjusted Straight Wire brackets. Comprehensive aligner tx was not around back then lol.

I see all the new orthodontists going through the DSO I work at. I see their work because I substitute for them when they are on vacation, or out sick. Most of them are adverse to wire bending. It's like they were never taught the fundamentals of moving teeth. They don't finish their cases in stainless steel archwires, adjustable archwires with proper adjustments. Closing extraction spaces without correcting the deep OB 1st. Inadequate upper incisor torque during space closure, etc. etc.

Aligner tx has even made this situation worse. Orthodontists relying too much on aligners to do the work.

As for choosing an ortho program. I attended a stipend paying, hospital based program on the east coast. Lots of extractions. Lots of orthognathic cases/craniofacial cases. Lots of Tweed concepts, Charles Burstone (extraction protocols). Well. After residency .... I moved back to Arizona. Well .... at that time the west coast was mostly NON-EXTRACTION concepts. Phase 1 treatment. RPE. Pendex. Hilgers. Herbst. T-Rex. Tads with upper molar distalizations using Niti wire (Giannely). Anything to treat nonextraction. Essentially the OPPOSITE of what I was trained for. I associated with a great orthodontist (18 mos later bought that practice) and learned this nonextraction technique. I used that nonextraction technique for years in private practice. Served me well. Funny thing is now working for a DSO .... I'm back to the simpler extraction treatment without appliances.

Point is. A residency should teach you the basics. The concepts you eventually use will be different depending on where you plan to practice. The thesis intent is to train you to be a discerning reader of publications, articles, for profit companies bragging about how good their product is, or speakers at a convention who have a financial interest in their lecture.
Do you believe the resident who only starts 20-30 cases during residency at school X is at a severe disadvantage compared to a resident that starts 70-80 cases at school Y?
 
Unless you are a legacy, a rockstar or other similar level celebrity, or a super charming person who can work the room the moment you walk in, you aren't going to have the luxury of where to attend residency and will be at the mercy of the match list. Unless you commit to a non-match program I guess.
 
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Unless you are a legacy, a rockstar or other similar level celebrity, or a super charming person who can work the room the moment you walk in, you aren't going to have the luxury of where to attend residency and will be at the mercy of the match list. Unless you commit to a non-match program I guess.
Exactly. I was not a top 5 applicant. I was extremely lucky to have landed a stipend paying residency. Sometimes it's who you know. I was close to one of my ortho instructors at dental school undergrad. He then found employment with the hospital ortho residency where I later interviewed. He was one of the interviewers. Just lucky I suppose.

Do you believe the resident who only starts 20-30 cases during residency at school X is at a severe disadvantage compared to a resident that starts 70-80 cases at school Y?
Not at all. Ortho tx is unique in that it is accomplished over a number of years. You will spend a LIFETIME learning. I'm still learning lol. Experience is everything with proper ortho tx. It's easy to start a number of cases, but the real learning comes years later when those same patients are in retention. That's where you will see if your initial diagnosis and preferred tx mechanics have been successful. I carefully review the final records on all of my completed patients. I'm always looking to see if I could have done things differently. But the the true test is the patients in retention. Will your tx hold up?

Again. Approach residency with an objective of learning the fundamentals. You can be the best orthodontist in the world, but that won't save you from an incorrect initial diagnosis and tx plan. Learn diagnosis. Learn basic and complex wire bending. I'm not suggesting you waste your time bending a Hawley ret. But be proficient in applying the proper wire adjustments to allow proper finishing of your cases.

As a resident .... you will start your own cases, but you will also be inheriting cases from the upper class residents. These inherited cases will have less educational value to you. Mostly because you were not involved in the initial diagnosis. You had no part in the placement of the braces (this is extremely important). You may or may not finish that case. And again .... you won't really know the success of your tx until that patient is in retention.

Diagnosis, Treatment Planning, and wire bending fundamentals is more important than the number of cases you start.

And don't get me started on aligner tx.
 
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Thanks everyone for providing your insight! Would it be too much to ask which programs you went to?
 
Thanks everyone for providing your insight! Would it be too much to ask which programs you went to?

My program no longer exists but 100 more have since opened so it doesn’t matter anyways. It was a hospital residency so I am a bit biased toward those but there are only a handful of those.
 
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